Syringe with disinfecting tip feature

ABSTRACT

Syringe assemblies comprising a disinfecting reservoir collar to ensure an adherence to aseptic techniques for use in flush procedures for vascular access devices (VAD&#39;s) are described. The syringe assemblies include a plunger rod, a syringe barrel, and the reservoir collar that permits disinfection of a hub of a VAD connector upon connection to the reservoir collar. Also described are methods of disinfecting the vascular access devices.

CROSS-REFERENCE TO RELATED APPLICATIONS

This Application is a divisional of U.S. patent application Ser. No.13/250,097 filed Sep. 30, 2011, the disclosure of which is herebyincorporated by reference in its entirety.

TECHNICAL FIELD

The present invention relates to syringe assemblies and particularly tosyringe assemblies comprising a disinfecting reservoir collar to ensureadherence to aseptic techniques for use in flush procedures for vascularaccess devices (VAD's).

BACKGROUND

VAD's are commonly used therapeutic devices and include intravenous (IV)catheters. There are two general classifications of VAD's, peripheralcatheters and central venous catheters. To ensure VAD's are used andmaintained correctly, standards of practice have been developed, whichinclude a cleaning procedure, commonly referred to as flushing acatheter.

VAD standards of practice usually recommend that flush procedures beperformed after catheter placement, before fluid infusion, and beforeand after drug administration, blood sampling, transfusions andparenteral nutrition. The goal of these flush procedures is to confirmcatheter patency, avoid drug incompatibilities, ensure complete drugdose administration, prevent thrombus formation and minimize the risk ofblood stream infections. Flush procedures require different types andamounts of flush solutions. The most commonly used flush solutions aresaline and/or heparin lock solution. The type of flush solution andamount vary depending on the specific type of catheter. Flush solutionvolumes between 5 and 10 ml are most common but can range from 1 ml to20 ml.

For flush procedures, an IV line refers to a system that can include aVAD, a tubing set with clamp and a VAD connector as a termination.Common types of VAD connectors are covered by pierceable septums orpre-slit septums made of rubber or another elastomeric material, whichpermits insertion of a sharp needle cannula in order to infuse fluidsinto or to withdraw fluids from the catheter. Upon withdrawal of theneedle cannula, the septum seals itself. Ports having pre-slit septumsare used with blunt plastic cannula or the frusto-conically shaped tipof a syringe barrel. The syringe tip or the blunt plastic cannula (whichis usually attached to a syringe) is gently pushed through the pre-slitseptum to establish fluid communication.

IV valves, another type of VAD connector that does not require a needlehaving a sharp tip, are activated by the frusto-conically shaped tip ofa syringe barrel to allow fluid communication between the interior ofthe syringe and the catheter. These valves may contain features fordelivering fluid from a storage compartment in the valve to thecatheter, and are referred to in the art as positive displacementvalves. Such a valve is taught in U.S. Pat. No. 6,206,861.

Bacteria and other microorganisms may gain entry into a patient'svascular system from access hubs and ports/valves upon connection to theVAD to deliver the fluid or pharmaceutical. Each access hub (orport/valve or connection) is associated with some risk of transmitting acatheter related bloodstream infection (CRBSI), which can be costly andpotentially lethal.

Throughout the sequence of procedures associated with the transmissionof a microorganism that can cause a CRBSI, there are many risks ofcontact or contamination. Contamination can occur during drug mixing,attachment of a cannula, and insertion into the access hub. Because theprocedure to connect to a VAD is so common and simple, the riskassociated with entry into a patient's vascular system has often beenoverlooked. Presently, the risk to hospitals and patients is asubstantial function of the diligence of the clinician performing theconnection, and this diligence is largely uncontrollable.

Current “recommended practice” for aseptic IV line maintenance and IVdrug delivery practices require adherence to a stepwise process referredto as “SASH.” During the first step of the process, the cliniciancleans/disinfects (generally with an alcohol swab) the VAD connector.Second, a syringe containing saline is used to flush the IV line orcatheter (Saline flush), and then the VAD connector is disinfected asecond time. Third, the fluid or pharmaceutical therapy is administeredthrough the IV line or catheter (Administer therapy), the VAD connectoris disinfected a third time, followed by a second Saline flush step. Thefinal step, which is dependent upon the patient's need and institutionalpolicy, is a final disinfection of the VAD connector followed by aHeparin lock step, where a small amount of heparin is injected into theIV line or catheter to prevent the formation of thrombi or blood clots.At the conclusion of this tedious stepwise process, the inlet port ofthe VAD connector is left exposed to the environment. This “recommendedpractice” requires disinfecting the VAD connector after each step, andmakes IV line maintenance a very burdensome and time consuming process.Because the process is so cumbersome, clinicians very rarely implementthis “recommended practice” in its entirety, and, thus, patients areexposed to the risk of contracting CRBSIs. Microorganisms populateexposed connector inlet surfaces, and, when the “recommended practice”is not adhered to, the microorganisms can enter the IV line duringflushing. Furthermore, blood reflux into the IV line or catheter cancause clot formation inside the lines, and microorganisms from theconnector inlet surfaces can colonize blood clots inside the lines andinfect the patients during flushing.

A product currently available that aims to combat the problemsassociated with contaminated VAD connectors is the SwabCap®. This devicedisinfects a VAD connectors by covering the connector and protecting itfrom touch and airborne contamination after the cap has been applied. Asthe SwabCap® is twisted onto VAD connector, a foam pad inside the cap iscompressed, releasing the isopropyl alcohol that bathes and passivelydisinfects the top and threads of the VAD connector while the cap is inplace. Friction between the SwabCap® and VAD connector is essential toensure proper swabbing and disinfecting as the twisting action helpsfocus the alcohol on the targeted areas. However, for several reasons,the SwabCap® falls short of accomplishing the desired goal ofeffectively cleaning and disinfecting the VAD connector. First, the capsdo not always engage the threads on the catheter hub, so that frictionduring swabbing may be inefficient. Additionally, the caps are small,and thus, may result in touch contamination when they are being removed.Despite the fact that the caps are bright orange in color so thatcompliance can be visually confirmed, because the SwabCap® is a separateentity, only the most diligent clinician will utilize the cap afterevery step of the flush process. Thus, the cap does not ensurecompliance with aseptic technique.

Substantial morbid and mortal risk is, therefore, associated with anumber of routine procedures defined primarily by the uncontrollablediligence of the clinician administering the therapy. Unfortunately, theresult is that a substantial degree of unnecessary risk and injury, inthe form of CRBSIs, to patients occurs. There is a need, therefore, fora flush syringe assembly that promotes compliance with aseptic techniqueby eliminating the additional swabbing and disinfecting steps.

SUMMARY

Embodiments of the present invention are directed to a syringe assemblyfor use in flush applications. Syringe assemblies according to a firstaspect of the present invention include a plunger rod, a syringe barrel,and a reservoir collar that permit disinfection of the hub of a VADconnector upon connection to the device. The features providing fordisinfection allow the clinician to substantially achieve the effects ofaseptic techniques without the need for added swabbing steps anddiligence on the part of the clinician.

In one or more embodiments, the disinfection is provided by a reservoircollar that contains a disinfectant housed within a compartment in thereservoir collar.

In one variant, the reservoir collar contains an absorbent material thatsurrounds a tip that is adapted for connection to a VAD. The absorbentmaterial absorbs the disinfectant, and, upon connection to the hub of aVAD connector, compresses toward the syringe barrel while disinfectingthe hub. The disinfectant can be a fluid, a foam, or a gel.

In a specific embodiment, the reservoir collar surrounds a connectorcollar adapted for connection to the hub of a VAD connector. In anotherspecific embodiment, the connector collar is a luer connector.

A second aspect of the present invention pertains to a method ofdisinfecting a VAD connector. The method according to one embodimentcomprises connecting a flush syringe assembly to the hub of a VADconnector, wherein the flush syringe assembly includes a plunger rod, asyringe barrel, and a reservoir collar that permits disinfection of thehub of a VAD connector upon connection to the device. The method allowsthe clinician to substantially achieve the effects of aseptic techniqueswithout the need for added swabbing steps and diligence on the part ofthe clinician.

In a specific embodiment, the method comprises connecting a flushsyringe assembly to a hub of the vascular access device, whereinconnecting includes frictionally engaging a reservoir having a collarand a tip on the flush syringe with the hub vascular access device suchthat the hub contacts an antimicrobial agent contained within thereservoir. As noted above, the reservoir can contain an absorbentmaterial, and the reservoir can include a first tip and a second tip,and the flush syringe includes a seal covering the reservoir and thefirst and second tip. In such construction, upon connecting the flushsyringe assembly to the hub, the seal is broken to expose the second tipto the antimicrobial agent. The reservoir further can comprises threadsthat engage threads on the hub, and connecting occurs by engaging thethreads on the hub and the reservoir by twisting the vascular accessdevice with respect to the flush syringe. Upon connection, the hubcontacts the antimicrobial agent and the absorbent material.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a flush syringe assembly according to anembodiment of the present invention;

FIG. 2 is an enlarged partially cross-sectioned side elevation view ofthe assembled reservoir collar attached to flush syringe assembly ofFIG. 1;

FIG. 3 is an enlarged partially cross-sectioned side elevation view ofthe components of the reservoir collar which attaches to the flushsyringe assembly of FIG. 1;

FIG. 4 is an enlarged partially cross-sectioned side elevation view ofthe assembled reservoir collar for attachment to flush syringe assemblyof FIG. 1;

FIG. 5 is an enlarged partially cross-sectioned side elevation view ofthe assembled reservoir collar being attached to the flush syringeassembly of FIG. 1;

FIG. 6 is an enlarged partially cross-sectioned side elevation view ofthe reservoir collar attached to the flush syringe assembly of FIG. 1,illustrating how the first tip of the syringe barrel attaches interlockswith the second tip of the reservoir collar;

FIG. 7 is an enlarged partially cross-sectioned side elevation view ofthe reservoir collar illustrating removal of the seal over the end ofthe reservoir collar for attachment to a VAD;

FIG. 8 is an enlarged partially cross-sectioned side elevation view ofthe reservoir collar illustrating attachment of the reservoir collar tothe hub of a VAD connector;

FIG. 9 is an enlarged partially cross-section side elevation view of thereservoir collar illustrating compression of the absorbent material uponconnection to the hub of a VAD connector;

FIG. 10 is an enlarged partially cross-sectioned side elevation view ofan alternative embodiment of the reservoir collar; and

FIG. 11 is an enlarged partially cross-sectioned side elevation view ofthe flush syringe assembly, illustrating an alternative embodiment ofthe reservoir collar for connection to the syringe assembly of FIG. 1.

DETAILED DESCRIPTION

Before describing several exemplary embodiments of the invention, it isto be understood that the invention is not limited to the details ofconstruction or process steps set forth in the following description.The invention is capable of other embodiments and of being practiced orbeing carried out in various ways.

With respect to terms used in this disclosure, the following definitionsare provided.

Reference to “flush syringe assembly” includes syringes that areindicated for use in the flushing of VADs. The practice of flushingensures and maintains catheter patency and helps prevent the mixing ofincompatible pharmaceuticals.

As used herein, the use of “a,” “an,” and “the” includes the singularand plural.

As used herein, the term “catheter related bloodstream infection” or“CRBSI” refers to any infection that results from the presence of acatheter or IV line.

As used herein, the term “microorganism” refers to a microbe or organismthat is unicellular or lives in a colony of cellular organisms.Microorganisms are very diverse; they include, but are not limited tobacteria, fungi, archaea, and protozoans. Microorganisms are often thecause of CRBSIs. The most common microorganisms associated with CRBSIsinclude, but are not limited to, Staphylococcus aureus and epidermis,Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, andCandida albicans.

As used herein, the terms “antimicrobial agent” or “antimicrobial”refers to substances that kill or inhibit the growth of microorganismssuch as bacteria, fungi, archaea, or protozoans. Antimicrobial agentseither kill microbes, or prevent the growth of microbes.

As used herein, the term “disinfectant” refers to antimicrobialsubstances that are used on non-living objects or outside the body,e.g., on the skin.

In one or more embodiments, disinfectants or antimicrobial agentinclude, but are not limited to, ethanol, 2-propanol, butanol,methylparaben, ethylparaben, propylparaben, propyl gallate, butylatedhydroxyanisole (BHA), butylated hydroxytoluene, t-butyl-hydroquinone,chloroxylenol, chlorohexidine, dichlorobenzyl alcohol, dehydroaceticacid, hexetidine, triclosan, hydrogen peroxide, colloidal silver, andmixtures thereof.

As used herein, the term “absorbent material” refers to a materialhaving capacity or tendency to absorb or soak up another substance. Inone or more embodiments, the absorbent material has a tendency to absorba disinfectant or antimicrobial. Absorbent materials may includesponges, absorbent cottons, other absorbent fabrics, and syntheticpolymer matrices.

As used herein, the term “Luer connector” refers to a connection collarthat is the standard way of attaching syringes, catheters, hubbedneedles, IV tubes, etc. to each other. The Luer connector consists ofmale and female interlocking tubes, slightly tapered to hold togetherbetter with even just a simple pressure/twist fit. Luer connectors canoptionally include an additional outer rim of threading, allowing themto be more secure. The Luer connector male end is generally associatedwith a flush syringe and can interlock and connect to the female endlocated on the VAD. A Luer connector comprises a distal end, a proximalend, an irregularly shaped outer wall, a profiled center passageway forfluid communication from the chamber of the barrel of a syringe to thehub of a VAD. A Luer connector also has a distal end channel thatreleasably attaches the Luer connector to the hub of a VAD, and aproximal end channel that releasably attaches the Luer connector to thebarrel of a syringe.

Provided are syringe assemblies that include a plunger rod and a syringebarrel, that incorporate an element for disinfecting the hub of a VAD.The assembled syringe assembly is shown in FIGS. 1 and 2, with thecomponents shown separately in FIGS. 3-9. Alternative embodiments of thepresent invention are shown in FIGS. 10-11 Referring to FIGS. 1-3, asyringe assembly 20 according to the present invention generallycomprises a barrel 21, including a side wall having an inside surfacedefining a chamber for retaining fluid. The barrel 21 further includesan open proximal end 27 and a distal end 28 having a distal wall 29 withan elongated first tip 31 extending distally therefrom and having afirst passageway 32 therethrough in fluid communication with thechamber, the tip adapted for connection to a reservoir collar 40. Thedistal wall 29 may comprise a plurality of threads for attachment to thereservoir collar 40.

An plunger rod 37 includes distal portion 38 and a proximal portion 39,the plunger rod further comprising a distal end including a stopperslidably positioned in fluid-tight engagement with the inside surface ofthe barrel for drawing fluid into and driving fluid out of the chamberby movement of the stopper relative to the barrel, the plunger rod 37extending outwardly from the open proximal end 27 of the barrel, thestopper having a distal surface.

A reservoir collar 40 mounted on the distal end 28 of the barrel andsurrounding the first tip 31, the reservoir collar 40 including at leastone side wall 41 having an inside surface 42 defining a compartment 43containing a disinfectant or antimicrobial agent, a sealed distal end45, and a proximal end 46 adjacent the distal wall 29 of the barrel,with a second tip 51 extending distally therefrom having a secondpassageway 52 therethrough in fluid communication with said firstpassageway 32, the second tip 51 adapted for connection to a hub of avascular access device. The reservoir collar 40 may comprise a pluralityof threads 47 on the inside surface for connection to a vascular accessdevice. The reservoir collar 40 may comprise a plurality of threads onthe proximal end for attachment to the distal wall 29 of the barrel.Referring to FIG. 5, upon manufacture, the flush syringe assembly 20 canbe provided with the reservoir collar 40 partially threaded at theproximal end 46 onto the distal wall 29 of the barrel. The seal 49, isnot yet pierced. Referring to FIG. 6, to activate the reservoir collar40, the clinician can twist the proximal end 46 onto the distal wall 29such that the threads tightly interlock and the first tip 31 pierces theseal 49. The first tip 31 then becomes interlocked with the second tip51, and the first passageway 32 and the second passageway 52 become oneintegral passageway for fluid communication from the barrel 21 to a VAD.

The reservoir collar 40 may comprise an absorbent material 44surrounding the second tip 51 for soaking up the disinfectant orantimicrobial agent that is housed within the compartment 43. Thedisinfectant or antimicrobial agent can be a fluid or a gel selectedfrom the group consisting of selected from the group consisting ofethanol, 2-propanol, butanol, methylparaben, ethylparaben,propylparaben, propyl gallate, butylated hydroxyanisole (BHA), butylatedhydroxytoluene, t-butyl-hydroquinone, chloroxylenol, chlorohexidine,dichlorobenzyl alcohol, dehydroacetic acid, hexetidine, triclosan,hydrogen peroxide, colloidal silver, and mixtures thereof.

The sealed distal end 45 of the reservoir collar 40 may comprise aremovable seal 48. The removable seal 48 can comprise an aluminum pealback top. The seal can be a plastic sealed aluminum, and can bechemically-resistant, light-blocking, non-permeable, or sterile.

The reservoir collar 40 may comprise an aluminum lining adhered to theinside surface 42 of at least one side wall 41. The aluminum lining canprevent degradation of the disinfectant or antimicrobial agent, and canalso provide a mechanism for ensuring compliance with asepticconditions.

The reservoir collar 40 may be removable from the syringe assembly 20.When removable, the reservoir collar 40 comprises a pierceable seal 49on the proximal end 46 of the reservoir collar 40. The pierceable seal49 can be pierced by the first tip 31 upon connection to the distal wall29 of the barrel. The pierceable seal 49 can comprise an aluminum seal.The aluminum seal can be a plastic sealed aluminum, and can bechemically-resistant, light-blocking, non-permeable, or sterile.

In an embodiment, the reservoir collar 40 surrounds a connector collaradapted for connection to the hub of the vascular access device. Theconnector collar can further comprise an absorbent material 44 forsoaking up the disinfectant or antimicrobial agent dispersed within theconnector collar. The disinfectant or antimicrobial agent can be a fluidor a gel. In a further embodiment, the reservoir collar 40 surrounds aconnector collar adapted for connection to the hub of the vascularaccess devices, wherein the connector collar is a Luer connector.

Referring to FIGS. 4-6, in operation, the assembled, removable reservoircollar 40 is attached via the proximal end 46 to the distal wall 29 ofthe syringe barrel 21 such that the proximal end 46 of the reservoircollar 40 is adjacent to the distal wall 29 of the syringe barrel 21.The first tip 31 interlocks with the second tip 51 such that the firstpassageway 32 and the second passageway 52 become one integralpassageway for fluid communication to a vascular access device.Referring to FIG. 5, upon manufacture, the flush syringe assembly 20 canbe provided with the reservoir collar 40 partially threaded at theproximal end 46 onto the distal wall 29 of the barrel 21. The seal 49 isnot yet pierced. Referring to FIG. 6, to activate the reservoir collar40, the clinician can twist the proximal end 46 onto the distal wall 29such that the threads tightly interlock and the first tip 31 pierces theseal 49. The first tip 31 then becomes interlocked with the second tip51, and the first passageway 32 and the second passageway 52 become oneintegral passageway for fluid communication from the barrel 21 to a VAD.Once the reservoir collar 40 has been activated by threading it onto thedistal wall 29, it is now ready to be used to disinfect the hub of aVAD.

The syringe assembly 20 is filled with flush solution using knownmethods. Additionally, the syringe assembly 20 may be providedpre-filled from the manufacturer or supplier. The flush solution may beany solution intended for flushing or maintaining performance of VAD's.It is preferred that the flush solution be selected from the groupconsisting of saline flush solution and heparin lock flush solution.These solutions are known in the art and are readily available. Anexample of a saline flush solution includes, but is not limited to, 0.9%sodium chloride USP for injection. An example of a heparin lock flushsolution includes but is not limited to 0.9% sodium chloride with 100USP units of heparin sodium per mL or 10 USP units of heparin sodium permL. When the first tip 31 interlocks with the second tip 51, the flushsolution is communicated from the barrel 21 through the now integralfirst passageway 32 and second passageway 52 to a vascular accessdevice.

The syringe assembly 20 is now ready for use in flushing a vascularaccess device such as a catheter or IV set. IV sets can be very complexand may include multiple injection ports, valves, and/or othercomponents. For the purpose of illustrating the present invention, asimplified IV set or catheter hub 60 is illustrated in FIGS. 8 and 9.The hub 60 includes a housing hollow interior and a septum 61 at itsproximal end 62. A hollow IV line or catheter 64 extends from the distalend 63 from the housing. The IV site may be a valve having structure foraccepting the second tip 51 and being activated by the insertion of thesecond tip 51 to establish fluid communication with the IV line orcatheter 64.

There are two general classifications of VAD's, peripheral catheters andcentral venous catheters. Peripheral catheters are used to access veinsin the peripheral extremities such as the hand and ann. Peripheralcatheters are relatively short in length ranging from about 14 mm to 48mm in length, and are available in gauge sizes from about 16 to 24. Itis believed that the most commonly used peripheral catheters are 20gauge having an ID of about 0.81 mm (0.032 inch) and 22 gauge having anID of about 0.66 mm (0.026 inch), and having a length of about 25 mm to32 mm. As used herein, the term “peripheral catheter” is intended torefer to a 20 or 22 gauge catheter having a length of about 25 mm.Central venous catheters are substantially longer than peripheralcatheters and are inserted in the patient and terminate near the heart.

Referring to FIGS. 7-9, the syringe assembly 20 when connected withreservoir collar 40 has a second tip 51 that is rendered antimicrobialbecause it is surrounded by an absorbent material 44 that soaks updisinfectant or antimicrobial agent contained within compartment 43. Thenow antimicrobial tip 51 can be connected to a vascular access device.The seal 48 is removed from the distal end 45 of the reservoir collar40, exposing the second tip 51. As the syringe assembly 20 is connectedto the hub of a vascular access device 60, the absorbent material 44compresses creating friction. The disinfecting properties of thedisinfectant or antimicrobial agent contained within the chamber 43 thathas been absorbed by absorbent material 44, disinfect the hub 60, thusensuring compliance with aseptic technique. The friction created by thecompression of the absorbent material 44 is necessary to providedisinfection of the hub 60. Once the connection of the syringe assembly20 to the hub 60 is completed, the hub is properly disinfected, andfluid communication from the barrel 21 of the syringe to the vascularaccess device can occur. Fluid is drawn from the barrel 21 through theintegral first passageway 32 and second passageway 52 through the hub 60and into the IV or catheter 64. Because of the presence of the reservoircollar 40, fluid communication through a vascular access device and intoa patient is conducted under aseptic conditions without any additionalswabbing steps and diligence on the part of the clinician.

FIG. 10 illustrates an alternative embodiment of the reservoir collar40. Additional space 70 between the plurality of threads 47 and theproximal end 46, allows the clinician to fully rotate the syringeassembly 20 and completely disinfect the hub 60 of a vascular accessdevice upon connection of the syringe assembly 20 to the hub 60.

FIG. 11 illustrates another embodiment of the syringe assembly 20. Thereservoir collar 40 can be integrally formed on the distal wall 29 ofthe syringe barrel 21 with a second tip 51 with a second passageway 52extending therethrough for fluid communication to the vascular accessdevice. A seal 48 will contain the disinfectant or antimicrobial agentwithin the chamber 43 until the seal 48 is removed and the syringeassembly 20 is connected to a vascular access device. The absorbentmaterial 44 will soak up the disinfectant or antimicrobial agent andwill disinfect the hub of a vascular access device upon connection. Thisalternative syringe assembly is simpler to manufacture compared to theassembly of FIGS. 1-3. However, extractables may increase.

Although the invention herein has been described with reference toparticular embodiments, it is to be understood that these embodimentsare merely illustrative of the principles and applications of thepresent invention. It is therefore to be understood that numerousmodifications may be made to the illustrative embodiments and that otherarrangements may be devised without departing from the spirit and scopeof the present invention as disclosed.

What is claimed is:
 1. A method of disinfecting a vascular accessdevice, the method comprising: obtaining a flush syringe having a barrelincluding a side wall having an inside surface defining a chamber forretaining a fluid, the barrel further includes an open proximal end, adistal end including a distal wall with an elongated first tip extendingdistally therefrom having a first passageway therethrough in fluidcommunication with said chamber, attaching a removable reservoir collarto the distal wall of the barrel to surround the elongated first tip,the reservoir collar including at least one side wall having an insidesurface defining a compartment containing a disinfectant or anantimicrobial agent, a sealed distal end of the reservoir collar havinga removable seal, a proximal end of the reservoir collar comprising apierceable seal adjacent the distal wall of the barrel, with a secondtip extending distally from the proximal end of the removable reservoircollar, a plurality of threads on the inside surface of the removablereservoir collar, an absorbent material in the compartment surroundingthe second tip, the absorbent material soaking up the disinfectant orthe antimicrobial agent contained in the compartment of the reservoircollar, the first tip interlocking the second tip, the second tip havinga second passageway therethrough in fluid communication with said firstpassageway of the elongated first tip of the flush syringe, the secondtip of the removable reservoir collar adapted for connection to a hub ofthe vascular access device, partially threading the reservoir collaronto the distal wall of the barrel of the flush syringe in an initialposition such that the pierceable seal of the proximal end of thereservoir collar is not pierced, activating the reservoir collar bytwisting the proximal end of the reservoir collar onto the distal wallof the barrel such that the first tip of the flush syringe pierces thepierceable seal of the proximal end of the reservoir collar and thefirst tip of the flush syringe interlocks with the second tip of theremovable reservoir collar to establish fluid communication between thefirst tip and the second tip; removing the removable seal of the distalend of the reservoir collar; connecting the hub of the vascular accessdevice to the reservoir collar to compress and create friction with theabsorbent material in the compartment.
 2. The method of claim 1, whereinupon connecting the hub of the vascular access device to the reservoircollar, the hub of the vascular access device contacts the disinfectantor the antimicrobial agent and the absorbent material contained in thecompartment.